Transcription

1 Please call 911 if you think you have a medical emergency. Treatment of Asthma The goals of asthma therapy are to prevent your child from having chronic and troublesome symptoms, to maintain your child's lung function as close to normal as possible, to allow your child to maintain normal physical activity levels (including exercise), to prevent recurrent asthma attacks and to reduce the need for emergency department visits or hospitalizations, and to provide medicines to your child that give the best results with the fewest side effects. Medicines that are available fall into two general categories. One category includes medications that are meant to control asthma in the long term and are used daily to prevent asthma attacks (controller medications). These can include inhaled corticosteroids, inhaled cromolyn or nedocromil, long-acting bronchodilators, theophylline, and leukotriene antagonists. The other category is medications that provide instant relief from symptoms (rescue medications). These include short-acting bronchodilators and systemic corticosteroids. Inhaled ipratropium may be used in addition to inhaled bronchodilators following asthma attacks or when asthma worsens. In general, doctors start with a high level of therapy following an asthma attack and then decrease treatment to the lowest possible level that still prevents asthma attacks and allows your child to have a normal life. Every child needs to follow a customized asthma management plan to control asthma symptoms. The severity of a child's asthma can both worsen and improve over time, so the type (category) of your child's asthma can change, which means different treatment can be required over time. Treatment should be reviewed every 1-6 months, and the choices for long- and shortterm therapy are based on how severe the asthma is. Talk to your doctor about the various medications available to treat asthma.

2 Severity of Asthma Long-Term Control Quick Relief Mild intermittent asthma Usually none Inhaled beta-2 agonist (shortacting Mild persistent asthma Moderate persistent asthma Severe persistent asthma Acute severe asthmatic episode (status asthmaticus) Daily use of low-dose inhaled corticosteroids or nonsteroidal agents such as cromolyn and nedocromil (anti-inflammatory treatment), leukotriene antagonists (such as montelukast) Daily use of medium-dose inhaled corticosteroids (antiinflammatory treatment) or lowor medium-dose inhaled corticosteroids combined with a long-acting bronchodilator or leukotriene antagonist Daily use of high-dose inhaled corticosteroids (antiinflammatory treatment), longacting bronchodilator, leukotriene antagonist, theophylline, omalizumab (for patients with moderate-tosevere asthma brought on by seasonal allergens despite inhaled corticosteroids) This is severe asthma that often requires admission to the emergency department or hospital. inhaler more than 2 times per week, long-term control therapy may be necessary. Inhaled beta-2 agonist (shortacting inhaler everyday or starts using it more and more frequently, additional long-term therapy may be needed. Inhaled beta-2 agonist (shortacting inhaler everyday or starts using it with increasing frequency, additional long-term therapy may be needed. Inhaled beta-2 agonist (shortacting inhaler everyday or starts using it with increasing frequency, additional long-term therapy may be needed. Repeated doses of inhaled beta-2 agonist (short-acting **Seek medical help Acute severe asthmatic episode (status asthmaticus) often requires medical attention. It is treated by providing oxygen or even mechanical ventilation in severe cases. Repeat or continuous doses from an inhaler (beta-2 agonist) reverse airway obstruction. If the asthma isn't corrected using the inhaled bronchodilator, injectable epinephrine and/or systemic corticosteroids are given to reduce inflammation. Fortunately, for most children, asthma can be well controlled. For many families, the learning process is the hardest part of controlling asthma. A child might have flares

3 (asthma attacks) while learning to control asthma, but don't be surprised or discouraged. Asthma control can take a little time and energy to master, but it's worth the effort! How long it takes to get asthma under control depends on the child's age, the severity of symptoms, how frequently flares occur, and how willing and able the family is to follow a doctor's prescribed treatment plan. Every child with asthma needs a doctorprescribed individualized asthma management plan to control symptoms and flares. This plan usually has 5 parts. The Five Parts to an Asthma Treatment Plan Step 1 - Identifying and controlling asthma triggers Children with asthma have different sets of triggers. Triggers are the factors that irritate the airways and cause asthma symptoms. Triggers can change seasonally and as a child grows older. Some common triggers are allergens, viral infections, irritants, exercise, breathing cold air, and weather changes. Identifying triggers and symptoms can take time. Keep a record of when symptoms occur and how long they last. Once patterns are discovered, some of the triggers can be avoided through environmental control measures, which are steps to reduce exposure to a child's allergy triggers. Talk with your doctor about starting with environmental control measures that will limit those allergens and irritants causing immediate problems for a child. Remember that allergies develop over time with continued exposure to allergens, so a child's asthma triggers may change over time. Others who provide care for your child, such as babysitters, daycare providers, or teachers must be informed and knowledgeable regarding your child's asthma treatment plan. Many schools have initiated programs for their staff to be educated about asthma and recognize severe asthma symptoms. The following are suggested environmental control measures for different allergens and irritants: Indoor controls o To control dust mites: Use only polyester-filled pillows and comforters (never feather or down). Use mite-proof covers (available at allergy

4 supply stores) over pillows and mattresses. Keep covers clean by vacuuming or wiping them down once a week. Wash your child's sheets and blankets once a week in very hot water (130 degrees Fahrenheit or higher) to kill dust mites. Keep upholstered furniture, window mini-blinds, and carpeting out of a child's bedroom and playroom because they can collect dust and dust mites (especially carpets). Use washable throw rugs and curtains and wash them in hot water weekly. Vinyl window shades that can be wiped down can also be used. Dust and vacuum weekly. If possible, use a vacuum specially designed to collect and trap dust mites (with a HEPA filter). Reduce the number of dust-collecting houseplants, books, knickknacks, and nonwashable stuffed animals in your home. Avoid humidifiers when possible because moist air promotes dust mite infestation. o To control pollens and molds: Avoid humidifiers because humidity promotes mold growth. If you must use a humidifier, keep it very clean to prevent mold from growing in the machine. Ventilate bathrooms, basements, and other damp places where mold can grow. Consider keeping a light on in closets and using a dehumidifier in basements to remove air moisture. Use air conditioning because it removes excess air moisture, filters out pollens from the outside, and provides air circulation throughout your home. Filters should be changed once a month. Avoid wallpaper and carpets in bathrooms because mold can grow under them. Use bleach to kill mold in bathrooms. Keep windows and doors shut during pollen season. o To control irritants: Do not smoke (or allow others to smoke) at home, even when a child is not present. Do not burn wood fires in fireplaces or wood stoves.

5 Avoid strong odors from paint, perfume, hair spray, disinfectants, chemical cleaners, air fresheners, and glues. o To control animal dander: If your child is allergic to a pet, you may have to consider finding a new home for the animal or keeping the pet outside at all times. It may (but does not always) help to wash the animal at least once a week to remove excess dander and collected pollens. Never allow the pet into the allergic child's bedroom. If you don't already own a pet and a child has asthma, don't acquire one. Even if a child isn't allergic to the animal now, he or she can become allergic with continued exposure. Outdoor controls o When mold or pollen counts are high, give your child medications recommended by your doctor (usually an antihistamine) before going outdoors. o After playing outdoors, the child should bathe and change clothes. o Drive with the car windows shut and air conditioning on during mold and pollen seasons. o Don't let a child mow the grass or rake leaves. In some cases, the doctor may recommend immunotherapy when control measures and medications are not effective. Speak with your child's doctor about these options. Step 2 - Anticipating and preventing asthma flares Patients with asthma have chronic inflammation of their airways. Inflamed airways are twitchy and tend to narrow (constrict) whenever they are exposed to any trigger (such as infection or an allergen). Some children with asthma may have increased inflammation in the lungs and airways everyday without knowing it. Their breathing may sound normal and wheeze-free when their airways are actually narrowing and becoming inflamed, making them prone to a flare. To better assess a child's breathing and determine risk for an asthma attack (or flare), breathing tests may be helpful. Breathing tests measure the volume and speed of air as it is exhaled from the lungs. Asthma specialists make several measurements with a spirometer, a computerized machine that takes detailed measurements of breathing ability.

6 At home, a peak flow meter (a hand-held tool that measures breathing ability) can be used to measure airflow. When peak flow readings drop, airway inflammation may be increasing. The peak flow meter can detect even subtle airway inflammation and obstruction, even when your child feels fine. In some cases, it can detect drops in peak flow readings 2-3 days before a flare occurs, providing plenty of time to treat and prevent it. Another way to know when a flare is brewing is to look for early warning signs. These signs are little changes in a child that signal medication adjustments may be needed (as directed in a child's individual asthma management plan) to prevent a flare. Early warning signs may indicate a flare hours or even a day before the appearance of obvious flare symptoms (such as wheezing and coughing). Children can develop changes in appearance, mood, or breathing, or they may say they "feel funny" in some way. Early warning signs are not always definite proof that a flare is coming, but they are signals to plan ahead, just in case. It can take some time to learn to recognize these little changes, but over time, recognizing them becomes easier. Parents with very young children who can't talk or use a peak flow meter often find early warning signs very helpful in predicting and preventing attacks. And early warning signs can be helpful for older children and even teenagers because they can learn to sense little changes in themselves. If they are old enough, they can adjust medication by themselves according to the asthma management plan, and if not, they can ask for help. Step 3 - Taking medications as prescribed Developing an effective medication plan to control a child's asthma can take a little time and trial and error. Different medications work more or less effectively for different kinds of asthma, and some medication combinations work well for some children but not for others. There are two main categories of asthma medications: quick-relief medications (rescue medications) and long-term preventive medications (controller medications) (see Treatment of Asthma). Asthma medications treat both symptoms and causes, so they effectively control asthma for nearly every child. Over-the-counter medications, home remedies, and herbal combinations are not substitutes for prescription asthma medication because they cannot reverse airway obstruction and they do not address the cause of many asthma flares. As a result, asthma is not controlled by these nonprescription medicines, and it may even become worse with their usage.

7 Step 4 - Controlling flares by following the doctor's written step-by-step plan When you follow the first 3 steps of asthma control, your child will have fewer asthma symptoms and flares. Remember that any child with asthma can still have an occasional flare (asthma attack), particularly during the learning period (between diagnosis and control) or after exposure to a very strong or new trigger. With the proper patient education, having medications on hand, and keen observation, families can learn to control nearly every asthma flare by starting treatment early, which will mean less emergency room visits and fewer admissions, if any, to the hospital. Your doctor should provide a written step-by-step plan outlining exactly what to do if a child has a flare. The plan is different for each child. Over time, families learn to recognize when to start treatment early and when to call the doctor for help. Step 5 - Learning more about asthma, new medications, and treatments Learning more about asthma and asthma treatment is the secret to successful asthma control. There are several organizations you can contact for information, videos, books, educational video games, and pamphlets. For more information, read the complete article, Asthma in Children (http://www.emedicinehealth.com/script/main/art.asp?articlekey=59201) on WebMD Medical Reference from emedicinehealth Reviewed by Jonathan L. Gelfand, M.D. on August 3, 2007 Last updated: August 3, 2007 This information is not intended to replace the advice of a doctor WebMD Inc. All rights reserved.

14 Where kids come first Childhood asthma In Canada, childhood asthma has quadrupled in the last decade. It is one of the most common reasons children are hospitalized or visit emergency departments. A

YOU VE BEEN REFERRED TO AN ASTHMA SPECIALIST... ...HERE S WHAT TO EXPECT You have been referred to an allergist because you have or may have asthma. The health professional who referred you wants you to

The Annual Direct Care of Asthma The annual direct health care cost of asthma in the United States is approximately $11.5 billion; indirect costs (e.g. lost productivity) add another $4.6 billion for a

Asthma Asthma is the term which describes a specific type of breathing problem that arises due to narrowing of the airways. This narrowing is caused when certain natural chemicals within the body are released,

Take Action on Asthma Environmental triggers of asthma and allergies What are asthma and allergies? They are both conditions where the body reacts to substances commonly found in the air. Asthma is a very

1 of 5 6/5/2014 9:36 AM Return to Web version Allergic Rhinitis Overview What is an allergy? You have an allergy when your body overreacts to things that don't cause problems for most people. These things

ASTHMA IN INFANTS AND YOUNG CHILDREN What is Asthma? Asthma is a chronic inflammatory disease of the airways. Symptoms of asthma are variable. That means that they can be mild to severe, intermittent to

American Journal of Respiratory and Critical Care Medicine American Journal of Respiratory Cell and Molecular Biology Proceedings of the American Thoracic Society MONICA KRAFT, MD President PATRICIA W.

The Right Medicines Can Help You Get Control of Asthma BlueCare SM TennCareSelect WHEEZING. COUGHING. SHORTNESS OF BREATH. CHEST TIGHTNESS. If you or a family member has asthma, you know these symptoms

7 Asthma Asthma is a common disease in children and its incidence has been increasing in recent years. Between 10-15% of children have been diagnosed with asthma. It is therefore a condition that pharmacists

Seasonal Allergies Introduction Seasonal allergies are allergies that develop during certain times of the year. Seasonal allergies are usually a response to pollen from trees, grasses, and weeds. Constant

Medicines Use Review Supporting Information for Asthma Patients What is asthma? Asthma is a chronic inflammatory disorder of the airways. The inflammation causes an associated increase in airway hyper-responsiveness,

If you need advice on taking over-the-counter medicines speak to a pharmacist or call the Consumer Health Information Centre s Over-the-Counter Medicines Advice Line on 020 8742 7042. The advice line is

The Proper Treatment Of Asthma Southwest Allergy & Asthma Foundation Page 1 of 10 INTRODUCTION The purpose of this pamphlet is to supply information which will give patients suffering with asthma, an intelligent

An Overview of Asthma - Diagnosis and Treatment Asthma is a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness,

What is allergic rhinitis? Allergic rhinitis means allergies in the nose. Hay fever is allergies that occur during a certain season of the year. What are the symptoms? nasal congestion sneezing tearing

Environmental Asthma Triggers Kit Overview This is an activity used to demonstrate environmental asthma triggers and solutions 1-on-1 or with small audiences in the home or clinical environment. Learning

Summer 2002 and wellness news for members with asthma AsthmaHealth Welcome to Healthy Horizons Welcome to the latest issue of Healthy Horizons, a newsletter designed by our Disease Management department

Background information Asthma Asthma is a complex disease affecting the lungs that can be managed but cannot be cured. 1 Asthma can be controlled well in most people most of the time, although some people

So You HaveAsthma So You HaveAsthma NIH Publication No. 07-5248 March 2007 Contents Introduction.......................................................1 Asthma Some Basics..............................................3

Get Your Head In The Game Matthew Voorman, MD Hutchinson Clinic March 21, 2016 About Me Otolaryngology Head & Neck Surgery Geisinger Medical Center General Surgery University of California San Francisco

CHILDREN S NATIONAL MEDICAL CENTER The Diana L. and Stephen A. Goldberg Center for Community Pediatric Health Asthma A Guide for Patients and Families Kohl s is proud to partner with Children s National

Asthma and Housing What s the Evidence What Can We Do? Margaret Reid, Director, Asthma and Diabetes Prevention and Control Emily Litonjua, Senior Program Manager for Healthy Homes Megan Sandel, MD MPH,

Asthma Basics Patient and Family Education This teaching sheet contains general information only. Talk with your child s doctor or a member of your child s healthcare team about specific care of your child.

GLOBAL INITIATIVE FOR ASTHMA What You And Your Family Can Do About Asthma BASED ON THE GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION NHLBI/WHO WORKSHOP REPORT NATIONAL INSTITUTES OF HEALTH NATIONAL

DO YOU HAVE ITCHY ALLERGY EYES? Find out about lasting relief Common causes of itching due to eye allergies include: Pollen from trees, grasses, and ragweed Dust mites Cat dander Approximately 10 million

II. ASTHMA BASICS Overview of Asthma Why do I need to know about asthma? In the United States, asthma is the most common chronic childhood illness. Asthma affects an estimated 4.8 million children nationally,

Script Notes: Good (morning, afternoon, evening), my name is, and I will present Asthma Basics for Schools. My goal today is to help you learn more about asthma and the school age child, as well as the

Hay Fever Introduction Hay fever is another name for a pollen allergy. Trees, weeds and grasses release tiny pollen grains into the air. When pollen gets into your nose and throat, it can cause an allergic

PATIENT INFORMATION ABOUT TREATMENTS FOR ASTHMA AND ALLERGIC RHINITIS, PRESCRIPTIONS & OVER THE COUNTER MEDICINE The content of this booklet was developed by Allergy UK. MSD reviewed this booklet to comment

Help Your Child Gain Control Over Asthma United States Environmental Protection Agency Indoor Environments Division Office of Air and Radiation EPA 402-F-04-021 November 2004 It s hard to see your child

Live well with COPD 1 Understanding COPD Chronic Obstructive Pulmonary Disease describes several different lung conditions that can lead to blocking the airflow out of the lungs. Breathing can become more

This article was published in the FMLA Policy, Practice, and Legal Update newsletter, by Business & Legal Reports, Inc. (BLR). BLR is a nationally recognized publisher of regulatory and legal compliance

Chapter 31 Drugs Used to Treat Lower Respiratory Disease Learning Objectives Describe the physiology of respirations Compare the physiologic responses of the respiratory system to emphysema, chronic bronchitis,

Dear Parent/Guardian, We all want our children with asthma to be healthy! Asthma can be a frightening experience for kids, as well as their parents. Let Darby BoIngg be your partner, along with your physician,

TAKING CARE OF YOUR ASTHMA WHAT IS ASTHMA? Asthma is a disease that affects the lungs. If you have asthma, you have it all the time, but will have an asthma attack only when something, known as a trigger,

Classifying Asthma Severity and Initiating Treatment in Children 0 4 Years of Age Components of Severity Symptoms Intermittent 2 days/week Classification of Asthma Severity (0 4 years of age) Persistent

Asthma Pocket Guide for Primary Care Annotated from the NAEPP/NHLBI Updated Asthma Guidelines and Developed Through Expert Consensus POSITION STATEMENT Despite advances in therapy, asthma remains a disease

5 Asthma Triggers Asthma triggers are allergens and irritants that aggravate the lungs and trigger asthma attacks (also called asthma episodes or flare-ups). One of the best ways to prevent an asthma attack

Asthma Intervention 1. Primary disease education Member will have an increased understanding of asthma and the classification by severity, the risks and the complications. Define asthma Explain how lungs

Help Yourself to a Healthy Home Asthma and Allergies SHOULD YOU BE CONCERNED? More than eight million children in the United States have a disease called asthma. Asthma is a leading reason that children

Consumers Allergic rhinitis and your Asthma What you should know Contents Allergic rhinitis facts...3 How allergic rhinitis can affect your asthma...3 What are the symptoms of allergic rhinitis?...4 What

Allergy is a condition in which the immune system causes sneezing, itching, rashes, and wheezing, or sometimes even life-threatening allergic reactions. The more you know about allergies, the better prepared

Childhood Asthma / Wheeze Symptoms Asthma causes a range of breathing problems. These include wheezing, feeling of tightness in the lungs/chest and a cough (often in the night or early morning). The most

SEVERE ASTHMA understanding the professional guidelines This guide includes information on what the European Respiratory Society (ERS) and the American Thoracic Society (ATS) have said about severe asthma.

Asthma Ear Infections in childhood asthma in childhood Asthma in childhood is common and it can be serious. About one in six children (aged less than 15 years) in Western Australia are affected by asthma.

"Respiratory Problems in Swimmers: How to keep Swimmers Afloat" and in the Pool! Charles Siegel, MD Associate Clinical Professor University of Missouri @ Kansas City School of Medicine USA Swimming does

Help Yourself to a Healthy Home Mold and Moisture SHOULD YOU BE CONCERNED? Mold produces spores, tiny specks you can t see and that float through the air. When you breathe in mold spores, they get into

Royal Manchester Children s Hospital Asthma Information For Parents and Carers Ward: Ward Telephone Number: Consultant: Understanding asthma Asthma is a common condition that affects approximately 1 in

Welcome to today s School Nurse Webinar Asthma Triggers and Management Webinar October 15, 2013 To set up your audio to listen to today s webinar, please complete the following steps. Open the Tools menu

w that Your Building Experienced Water Damage What Must You and Your Water Damage Restoration Contractor Agree On? By Completing a Building and Occupant Survey Hopefully Your Questions will be Answered

United States Environmental Protection Agency ASTHMA HOME EVIROMET 5 C H E C K L I S T Home visits provide an opportunity to educate and equip asthma patients with the tools to effectively manage their

A New Way to Feel the Relief From Your Allergy and Asthma Symptoms Guaranteed Doing Nothing Can Make Something Annoying, Bad and Something Bad, Worse Exposure to dust mite and pet allergen are widely accepted

Asthma Action Plan PROVIDER INSTRUCTIONS At initial presentation, determine the level of asthma severity Level of severity is determined by both impairment and risk and is assigned to the most severe category

Better Breathing with COPD People with Chronic Obstructive Pulmonary Disease (COPD) often benefit from learning different breathing techniques. Pursed Lip Breathing Pursed Lip Breathing (PLB) can be very

A ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy. RAGWITEK is a prescription medicine used for sublingual (under the tongue) immunotherapy to treat ragweed pollen allergies

Certification Program Guide for Reducing Allergens and Irritants in the Home Indoor environmental control tips from the asthma & allergy friendly TM Certification Program www.asthmaandallergyfriendly.com

Treatment of sthma in hildren 5. Treatment of sthma in hildren 5.1 Maintenance Treatment 5.1.1 rugs Inhaled Glucocorticoids. Persistent wheezing in children under the age of three can be controlled with

Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease (COPD) is the name for a group of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways

Asthma Triggers What are they and what can be done about them? This brochure has been developed for the community by Asthma Australia It provides information about: Asthma triggers What you can do about

PUBLIC HEALTH DIVISION http://public.health.oregon.gov Wildfire Smoke and Your Health When smoke levels are high, even healthy people may have symptoms or health problems. The best thing to do is to limit

written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd What Is COPD? COPD stands for chronic obstructive pulmonary disease. There are two major diseases included in

Lung Disease page 1 Q: What is lung disease? A: Lung disease refers to disorders that affect the lungs, the organs that allow us to breathe. Breathing problems caused by lung disease may prevent the body

Understanding asthma Oxford Self-help guide Oxford Living with asthma Years ago, asthma was a debilitating condition that in many cases seriously limited what a person could do. Fortunately as a result

Office of Environmental Health & Safety Got Mold? Frequently Asked Questions About Mold What are molds? With more than 100,000 species in the world, it is no wonder molds can be found everywhere. Neither

COUGH Cough, as a leading symptom, would certainly be in the top 10 of reasons for seeing a GP. A cough in a child seems to cause more concern, even when it has not been present very long, whereas in adults

Indoor Air Quality FILL YOUR HOME WITH AIR THAT IS AS CLEAN AS IT IS COMFORTABLE. QUALITY AIR STARTS HERE. AccuExchange Energy Recovery Ventilator Improve your home s indoor environment by exchanging stale